What do people think about the new 111 service?

Does it have a name? Neither of the obvious domains, www.nhs111.nhs.uk and www.111.nhs.uk, are valid. There is nothing on the NHS Choices homepage about it.  :-?


I understand that it will deal with calls for out of hours GP services, so no longer will there be a need for each area to have its own number. I am concerned by reports that staff answering calls will not be medically qualified, unlike with those on NHS Direct.

Those taking calls on the National Pandemic Flu Service weren't qualified either and just read from flow-charts prepared by doctors. Was this considered a success and do we think that this has played its part in the design of the new 111 service?

I think that professional advice being available over the phone is an indespensible property of NHS Direct.

I think they are going to keep nhsdirect as a website, or change it into choices.

mc661 wrote on Oct 31^st, 2010 at 12:33am:

I think they are going to keep nhsdirect as a website, or change it into choices.

The telephone advice and information service on 0845 4647 is one of a number of services provided by the NHS Direct NHS Trust. This is a national service for England. The NHS Direct NHS Trust is commissioned to provide many other national and local services, including the web site that carries its name.

The 111 service will be commissioned / provided locally, by whoever is responsible for providing primary care to each locality. At present this is the PCT, under the proposals in the White Paper this would be the GP Consortium.

Provision of the 111 service may involve a number of commissioned bodies. The pilots include involvement from Ambulance Trusts and from the NHS Direct NHS Trust. Whilst the 111 service will have to include the same basic triage that is undertaken when calling 0845 4647, or any out-of-hours GP service (both of which it will replace for initial call handling) it is not essentially proposed to offer the same level of advice and information by telephone that is currently provided on 0845 4647.

Whilst qualified nurses may need to be available to support trained call handlers with tricky triage situations, the intention was (and perhaps still is) not to provide the detailed advice which NHS Direct nursing staff are currently providing by telephone. There are both clinical and economic arguments against this approach. It could be that some consortia will offer a full advice and information service, equivalent to the present "NHS Direct" service. It could be that they would commission the NHS Direct NHS Trust to provide it, or they could choose another body from any sector to provide this service. Once the experience of the pilots has been evaluated, and assuming that the reforms go through, it will be for the Commissioning Board to lay down the mandatory service standards for the 111 service.

It has been suggested that the NHS Direct service on 0845 4647 will be retained until the 111 service has been rolled out throughout England and this this will take 3 years. We will have to see whether GP Consortia will be compelled to commission and implement their 111 service within a particular time frame. Given the difficulties that are likely to be encountered in passing over responsibility for vital existing services from people who face redundancy to a wholly new type of organisation, I anticipate a considerable delay in getting 111 up and running. Achieving the necessary coordination between various different bodies, on which 111 relies, was going to be difficult enough anyway in some areas. Giving the job to a group of people who have been deliberately chosen because they are novices in the role of managing public sector provision for a community is likely to present serious problems for the creation of a new complex integrated structure.

Like any commissioned NHS provider, the NHS Direct NHS Trust is fighting to maintain its share of the market and trading on the reputation associated with its brand. It has made it clear that it hopes to take a leading role in the provision of the 111 service wherever it is rolled out. It will however have to bid for this work alongside competitors from all sectors when each local contract is put out to tender.

When the SHAs are abolished, national services (for England) will be commissioned directly by the Department of Health - that could already be the case for the NHS Direct website. NHS Choices is currently run directly by the Department of Health. Had it been the intention to abolish the NHS Direct NHS Trust, I am sure that this would have been announced. As the NHS Direct NHS Trust is itself a provider in the NHS marketplace it is obviously unsuitable to undertake the operation of NHS Choices. When given Foundation Trust status, along with all other NHS bodies, after its previous attempt to bid for this was blocked by the previous government, who knows how it will seek to grow its role in the NHS.

I hope that this is as clear as it could be, and helpful.

New NHS number to restore out-of-hours care for all non-emergencies

By James Chapman And Kirsty Walker

Last updated at 9:30 AM on 1st October 2011

An urgent care number is to be introduced to replace NHS Direct.

The free 111 service – for all non-emergency care and advice – is designed to restore out of hours help, according to David Cameron.

Like NHS Direct, the new number will dispense advice, but it will also secure an ambulance, GP or community nurse day and night.
Instant care: The new free service staffed by trained call advisers, supported by nurses will be open 24 hours a day all year round

Instant care: The new free service staffed by trained call advisers, supported by nurses will be open 24 hours a day all year round

Patients will not have to wait for a doctor to call them back, as often happens when they try to reach out-of-hours services run by their GP.

The service will also allow patients to book appointments at their family doctor for the next day. ‘We are announcing what you will be getting from a new national service in the NHS – one that is emblematic of the patient power we’re bringing,’ Mr Cameron told the Daily Mail.

‘Today, if your child wakes in the middle of the night because they’ve got a burning sore throat you can end up sitting around in A&E for hours.



'We’re going to make sure you are seen by the right doctor or nurse in the most convenient place. We are abolishing the whole concept of out of hours. Our NHS will be a 24/7 one.

'I believe people should get the care they need, when and where they need it.

'However, too many people are confused about what is available to them or how best to get it, especially at night or if they are away from home.

'That's why we are introducing NHS 111. The new service will make sure callers can access the care and advice that is right for them, 24 hours a day, 365 days a year.'

The service will be free to call and staffed by a team of trained call advisers, supported by nurses, who will be on hand to assess needs 24 hours a day, 365 days a year. If they believe emergency care is required, an ambulance will be dispatched straight away.

The number has been piloted in County Durham and Darlington, Nottingham City, Lincolnshire and Luton, but Mr Cameron says it will be rolled out nationwide from April 2013, replacing the NHS Direct 0845 4647 line.

Figures suggest that up to two out of three patients calling NHS Direct end up being sent to see a doctor, dentist or pharmacist – half of them classified as urgent or emergency cases.

Source:
http://www.dailymail.co.uk/news/article-2044005/New-NHS-number-restore-hours-care-non-emergencies.html

There seems to be a NHS 111 Page here but it doesn't seem to give much info that's helpful.  :-/

CJT-80 wrote on Oct 1^st, 2011 at 9:53pm:

There seems to be a NHS 111 Page here but it doesn't seem to give much info that's helpful.  :-/

Other than this


The line will be staffed round the clock, 365 days a year. Calls from landlines and mobile phones are free.

Indeed Sherbert,

Perhaps someone in the "available" areas can test this?

I received an email today from NHS24, the Scottish version of NHS Direct. Apart from assuring me they make no money presently from 0845 and that:

Quote:

The use of the local rate number replicates the tariffs which would have been levied on callers accessing Out of Hours Services before the existence of NHS 24, when calling from a BT landline

??  :-/

They also said:

Quote:

Work is underway to consider the use of a three digit number, which will be free for the caller to our service. This is being piloted in areas of England and progress is being monitored to evaluate this before determining if this would be appropriate for possible implementation in Scotland

.

CJT-80 wrote on Oct 3^rd, 2011 at 4:23pm:

Indeed Sherbert, Perhaps someone in the "available" areas can test this?

I have checked this out with a number of telcos - all of which seem to be on the ball, although not all are advising of this in their published tariffs.

As with the implementation of 03, if we find that some telcos have got it wrong, it is likely that they will swiftly fall in line.


I have many reservations and doubts about 111, although not about the cost to callers. As many people can now call a geographic or 03 number without any call charge it is disturbing that the NHS is going to be paying the telcos for connecting every call, as well as for the complex technology required to route each call to the correct local centre.

In some areas there are going to be major problems, as the area information available will not be sufficiently precise to identify the correct local centre.


I also have major concerns about the cost of the service at a time when budgets are being tightened. The original idea was to have something that was cheaper than the NHS Direct advice and information service and swiftly directed patients to the most appropriate local service. I fear that we will end up with something that is more expensive than NHS Direct and ends up sucking money out of the proper services to which it was intended to direct people.

A hideous worst case scenario is that 111 will end up being all that is left of the NHS at the front door, because (along with the NHS Direct on-line service) it will have consumed all of the NHS Primary Care budget, so that most of us will have to pay if we actually want to see someone initially. (Pedestrian access to A&E will be via a phone booth.) In true Tory style, special arrangements will be made to provide free access to GPs for the "most needy", but that is not the universal NHS which many of us love and fight for.

http://www.dailymail.co.uk/health/article-2151506/Doctors-warn-new-NHS-111-phone-number-lead-THREE-TIMES-ambulance-outs.html

http://www.bbc.co.uk/news/health-18450428

sherbert wrote on Jun 14^th, 2012 at 7:07pm:

http://www.bbc.co.uk/news/health-18450428

Thanks for the tip-off.

The NHS Direct 084 telephone number rip-off is extended by at least six months

http://www.bbc.co.uk/news/health-21922711

Doctors are questioning the safety of a new non-emergency NHS telephone advice line that is due to launch 1 April.

The 111 service, which will replace NHS Direct in England, is being piloted in some regions ahead of a nationwide launch but has proved problematic, with some callers left on hold for hours.

Dr Laurence Buckman, the British Medical Association's GP committee chair, says rollout should be stalled.

The Department of Health says it is giving some areas extra time to launch.

It has already sanctioned an extension of up to six months of the original April 2013 deadline for regions struggling to set up the new service.

The BMA is seriously concerned that these failures are not only having impact on other, already overstretched NHS services, but potentially putting patient safety at risk”

The NHS Direct 0845 4647 service will continue to be available to callers in areas where the NHS 111 service is in the process of being introduced, Health Minister Lord Howe insists.

These include: North of Tyne and Tees, North Essex, Bedfordshire and Luton, Cambridgeshire and Peterborough, Leicestershire and Rutland, Berkshire, Cornwall and Devon.

But the British Medical Association is concerned that many of the places which are set to launch in the coming week are ill-prepared, putting patients' lives at risk.

The BMA says it has been receiving widespread reports of NHS 111 failures

Some of the pilot regions have been unable to cope with call volumes or have suffered catastrophic IT failures.

In Greater Manchester the entire system crashed, meaning calls went unanswered.

One elderly patient had to wait 90 minutes for a call back from NHS 111.

Problems led to a surge in ambulance callouts and casualty visits as callers have resorted to other measures to get seen by a healthcare professional.
'Reconsider rollout'

Dr Buckman said: "The BMA is seriously concerned that these failures are not only having impact on other, already overstretched NHS services, but potentially putting patient safety at risk. Patients need to have their calls answered immediately and correctly and not be faced with any form of delay.
Continue reading the main story      
NHS 111

    The free one-stop number is for patients with urgent, but not life-threatening symptoms
    This includes people needing fast medical help, but who are not a 999 emergency
    Trained advisers who answer the phones offer basic health advice and direct the caller to the most appropriate service for their needs - A&E or GP out-of-hours services, for example

"The Department of Health needs to reconsider immediately its launch of NHS 111 which clearly is not functioning properly. They must ensure that the system is safe for patients before it is rolled out any further."

Lord Howe said: "NHS 111 will help patients access the whole of the NHS through just one simple number.

"Over the coming months this new service will replace the existing NHS Direct telephone advice line. To ensure that patients get the best care and treatment, we are giving some areas more time to go live with NHS 111 while we carry out thorough testing to ensure that those services are reliable."

Quote:

Trained advisers who answer the phones offer basic health advice and direct the caller to the most appropriate service for their needs - A&E or GP out-of-hours services, for example

I don't understand the problem. 

I (in north Essex, where, apparently, 111 is due to go live in a few days), had occasion to call 08454647 last week and the service I received was exactly what is described above as being the 111 service.

So what's the problem with simply changing the phone number?

Heinz wrote on Mar 26^th, 2013 at 10:06am:

Quote: Trained advisers who answer the phones offer basic health advice and direct the caller to the most appropriate service for their needs - A&E or GP out-of-hours services, for example I don't understand the problem.  I (in north Essex, where, apparently, 111 is due to go live in a few days), had occasion to call 08454647 last week and the service I received was exactly what is described above as being the 111 service. So what's the problem with simply changing the phone number?

Technically there isn't an issue, the reason as far as I can see for changing from NHS Direct and it's 0845 number to NHS 111 and it's service is COST.  Basically it's cheaper to run NHS 111 overall than run NHS Direct!

Welcome to austerity! It now affects the NHS' front line telephone support roles, which were designed to reduce the numbers of people attending A&E with "minor" injuries.

:(

http://www.dailymail.co.uk/health/article-2300613/New-NHS-111-helpline-puts-patient-safety-risk-doctors-warn.html

http://www.dailymail.co.uk/health/article-2306791/New-NHS-phone-line-left-wife-intensive-care-Husbands-anger-took-14-HOURS-respond-elderly-diabetic-lady.html

I'm not sure how helpful it is to report every apparent failure of the 111 service here, and there will doubtless be many reported in the papers - it isn't really a telecoms issue. In this case, I think most people are rather puzzled as to why he didn't use the 999 service earlier.

kasg wrote on Apr 10^th, 2013 at 2:21pm:

I'm not sure how helpful it is to report every apparent failure of the 111 service here, and there will doubtless be many reported in the papers - it isn't really a telecoms issue. In this case, I think most people are rather puzzled as to why he didn't use the 999 service earlier.

Hear Hear!

Had the initial call in question been made to NHS Direct on 0845 4647, rather than 111, then the caller would have had to call again to make contact with the GP out of hours service for the area. This could have been through a 084 number used by their GP or directly to the out of hours provider, some of whom use 084 numbers. It may be that subsequent calls to chase up would have been answered more promptly, although hanging on for an answer on 111, at no cost to the caller, may have been cheaper than hanging on for an answer on another number. (It was not the actual call cost which caused the caller to hang up and try again later during the day.)

This is a most unhappy story, but the issues raised are not directly related to the choice of telephone number for 111. There may be an indirect relationship …

One fears that the most significant point may be the failure to rigidly enforce the principle that 111 is only for urgent, but non-emergency cases. The health information and advice telephone service offered by NHS Direct to cover non-urgent cases is being withdrawn. This information and advice is largely still available from other sources, but it is uneconomic to provide it in parallel with a telephone service intended for urgent cases, where calls need to be answered promptly. If, as may have happened in this case, the subsequent calls to 111 were not answered promptly because agents were dealing with non-urgent cases, then an argument could be made for setting a charge for calling 111. I would not support such an argument, but if the resources cannot be committed to 111 to ensure prompt access for urgent callers, then steps must be taken to stop 111 being used unnecessarily. One hopes that charging would be the last option to be considered!

NHS Direct has abandoned plans to down-band frontline staff because it needs to retain people to run its NHS 111 service

http://www.hsj.co.uk/news/commissioning/exclusive-nhs-direct-abandons-cost-cut-plans-following-111-debacle/5057932.article?blocktitle=Latest-News&contentID=8803

I couldn't find anywhere else to put this.. so here it is..

From April 2014 NHS 24's number will be replaced with NHS 111.. More info here: http://www.scotland.gov.uk/News/Releases/2013/01/111-number23012013

:)

edit: must learn to spell check!  ::)

Usage of 0845 46 47 in England by NHS Direct has now ended.

Usage of 0845 46 47 continues only in Wales.

For the sake of clarity, the Health Information and Advice Service provided by NHS Direct on 0845 4647 has been withdrawn in England. (This should have happened on 1 April 2013, but it had to be extended.) A new, locally-based service on 111 has been introduced to address only URGENT, but non-emergency, requirements. The "NHS Direct" service continues in Wales.

NHS 24, the Scottish equivalent of the former NHS Direct Service, is changing its telephone number from 0845 4 24 24 24 to 111.

"NHS Direct" is not only the name of the telephone service, but also of a special NHS Trust, set up to run both the telephone service (in England and, separately, in Wales) and also a on-line information service. This Trust was largely responsible for creating the confusion around 111, as it tendered for 111 contracts and tried to pretend that the same services could be provided at the lesser budget which was assigned. It subsequently had to withdraw from 111 contracts.

I called the New NHS Service 111 and needed a ambulance spoke to the doctor on the phone. His words were we only get ambulance coming to your house address.

Laura Anthony wrote on Mar 5^th, 2015 at 12:56pm:

I called the New NHS Service 111 and needed a ambulance spoke to the doctor on the phone. His words were we only get ambulance coming to your house address.

The 111 service is NOT FOR EMERGENCIES. All emergencies (e.g. emergency ambulances) are handled by the 999 service.

111 should be able to connect you to the emergency service, or contact it themselves - if they recognise that this is what is required.

There may be a problem in getting across the message that 111 is for URGENT, but NON-EMERGENCY access to the NHS by telephone. Non-urgent enquiries should be made to the GP or any relevant specialist service.

If this was a request for "patient transport" (sometimes referred to as an "ambulance", but different to the emergency situation in which the term is normally understood), then there was obviously a misunderstanding. 111 should have been able to redirect the call to the appropriate patient transport provider.

Laura Anthony wrote on Mar 5^th, 2015 at 12:56pm:

I called the New NHS Service 111 and needed a ambulance spoke to the doctor on the phone. His words were we only get ambulance coming to your house address.

It maybe worth reading this info on NHS 111: http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx

It will be interesting to see how this pans out